<INCLURE{fond=css/#FORM}>

<div class="feedback [(#ENV{config}|table_valeur{ajax}|=={1}|?{ajax})]">
<h3><:formulaire_feedback2col:feedback:></h3>
    <form action="#ENV{action}" method="post" class="form_#FORM [(#ENV{config}|table_valeur{google_analytics}|=={1}|?{google-analytics-form})]">
        <fieldset>
            [<div class="erreur">(#PDK_MESSAGE_ERROR{#FORM})</div>]
            [<div class="message-ok">(#PDK_MESSAGE_OK{#FORM})</div>]
            #ACTION_FORMULAIRE{#ENV{action}}
                <div class="feedback2col">
                    <div class="text">
                        <label for="name"><:formulaire_feedback2col:name:></label>
                        <input type="text" id="name" name="name" value="#ENV{name}" />
                        [<span class='erreur'>(#ENV**{erreurs}|table_valeur{name})</span>]
                    </div>
                    <div class="text">
                        <label for="email"><:formulaire_feedback2col:email:></label>
				        <input type="text" id="email" name="email" value="#ENV{email}" />
                        [<span class='erreur'>(#ENV**{erreurs}|table_valeur{email})</span>]
                    </div>
                    <div class="text">
                        <label for="phone"><:formulaire_feedback2col:phone:></label>
        				<input type="text" id="phone" name="phone" value="#ENV{phone}" />
                        [<span class='erreur'>(#ENV**{erreurs}|table_valeur{phone})</span>]
    				</div>
                </div>
                <div class="feedback2col">                    
                    <div class="textarea">
                        <label for="text"><:formulaire_feedback2col:text:></label>
						<textarea name="text" id="text" cols="10" rows="10">#ENV{text}</textarea>
                        [<span class='erreur'>(#ENV**{erreurs}|table_valeur{text})</span>]
                    </div>
                    
                    [(#REM)Insert upload files block]
                    <INCLURE{fond=inc/feedback_files_upload}{env}>
                                        
                    [(#REM)Insert captcha block]
                    <INCLURE{fond=inc/feedback_captcha}{env}>
    
                        <input type="submit" value="<:formulaire_feedback2col:send:>" class="submit" />
                </div>
</fieldset>
</form>
</div>